​There are many reasons why people choose to include sugar substitutes in their diet. For example, diabetics use them to control blood glucose levels, and many people use them to control calorie and sugar intake. Others use them to help prevent the tooth decay associated with sugar consumption. Regardless of the reason, sugar substitutes are widely used. Splenda alone generated sales of $287.8 million in the US in 2012 (http://www.statista.com/statistics/328748/us-retail-sales-of-splenda-artificial-sweetener/). At the same time, the media often mentions the negative effects of sugar substitutes so it is easy to be confused or to be convinced that sugar substitutes should be avoided. I chose to explore the truth behind sugar substitutes so I could share my thoughts with you.Question 1: What are the current sugar substitutes available on the Canadian market, where do we find them in food products and are they safe to consume? If so, how much?All sugar substitutes are metabolized differently in the body and therefore have a different effect on blood sugar levels as compared to sugar. Some sugar substitutes, such as Splenda, are minimally absorbed in the small intestine (less than 25%) which is why it provides 1 calorie/gram as compared to the 4 calories/gram found in table sugar.

The sugar substitutes regulated for use in Canada include sucralose (Splenda), aspartame, stevia, sugar alcohols, saccharin and cyclamate. Each of these have their own regulations on how they can be sold and what food products they can be used in. It is important to understand that sugar substitutes are considered safe when consumed in quantities outlined by their Acceptable Daily Intakes (ADI) set by Health Canada, which range from 40mg/kg/day (aspartame), 11mg/kg/day (Cyclamate), 9mg/kg/day (Splenda), to 4mg/kg/day (Stevia).

Aspartame is the sugar substitute that is probably the most well known. It is found in soft drinks, desserts, cereals, candies, gum, etc. It is a chemical that consists of 2 amino acids: aspartic acid and phenylalanine. Those who are living with phenylketonuria (PKU) must avoid aspartame due to its phenylalanine content. Most people can safely consume aspartame up to the ADI (40mg/kg body weight/day), however there is research showing that individuals who are susceptible to migraines may want to avoid aspartame.

Sucralose (Splenda) is another widely used sugar substitute. It is often found in baked goods, mixes for baked foods, as well as candy and soft drinks. Splenda is heat stable which is why it is often used in baked goods. Sucralose is made by replacing three ‘OH’ groups on a sugar molecule with chlorine. It is not broken down in the body the way sucrose (table sugar) is and therefore intestinal absorption is minimal. Like aspartame, sucralose may be linked to migraines. Sucralose is considered a safe sugar substitute when consumed below 15mg/kg body weight/day.

Sugar alcohols are ‘polyols’ which are found naturally in some fruits and vegetables. Those living with IBS or IBS-like symptoms may experience gastrointestinal (GI) or abdominal distress after consuming sugar alcohols as they are only partially absorbed in the intestine. Everyone should avoid consuming more than 10g/day of sugar alcohols, including the naturally occurring polyols in fruits and vegetables.

Saccharin and cyclamate (Sugar Twin or Sweet ‘N Low) are other sugar substitutes commonly seen in Canada. Neither are considered safe for children under 2 or for pregnant women. Otherwise, the ADI for saccharin is 0-5mg/kg body weight/day. These products are only approved as table-top sweeteners and therefore are not found in processed foods like baked goods and treats.

Lastly, stevia is a plant based sugar substitute that is extracted from stevia plant leaves. It is used as a table-top sweetener and is found in many natural health products as well as candy, gum, baking mixes, and snacks. The ADI for stevia is 4mg/kg/day.

Question 2: Do sugar substitutes deliver the results we are looking for? Such as reduced blood sugar levels, weight maintenance and a decrease in tooth decay?In terms of dental health, sugar substitutes are generally deemed ‘tooth friendly’ as they are not fermented like sugar by bacteria in the mouth and therefore do not cause dental decay. Sugar alcohols, in particular, may reduce the risk of dental caries.

For those trying to control post-meal blood sugar levels (i.e. diabetics), sugar substitutes have been seen to be beneficial in reducing these rates. However, there has been no observed cause and effect relationship between sugar substitutes and the maintenance of normal blood glucose concentrations overall.

Question #3- Given that the benefits of sugar substitutes are generally not well founded, what is the best course of action to take in terms of weight maintenance and blood glucose control?Rather than replacing sugar with alternative sweeteners, it is best to practice retraining your taste buds to enjoy semi-sweet foods, portion control, and consuming naturally sweetened fruits and vegetables. Otherwise, choose natural sweeteners such as raw honey, pure maple syrup, or blackstrap molasses as sugar sources because they provide nutrients along with a sweet flavour. Practicing portion control is key in this scenario. For example, 1 tsp of honey in a cup of coffee should suffice.

The way to weight maintenance and blood sugar control is not through the substitution of sugar with sugar substitutes but through a highly nutritious, well-balanced, varied diet with proper portion control.

There is no doubt that sustainable seafood should be included in the diet, provided one is not vegan or does not have allergies. Seafood is a significant source of lean protein, often accompanied by the well-known unsaturated fat, Omega 3. Omega 3’s are found in mackerel, herring, kippers, sardines, salmon and anchovies, amongst other fatty fish. Seafood is also loaded with vitamins and minerals required to keep our systems functioning properly and to keep us healthy and free from disease.

The nutrients that I am focusing on are ones that are incredibly important, yet are often missing in a typical North American diet. For example, Vitamin B12 is found only in animal products, including seafood. Vitamin B12 is required for the production of red blood cells, which carry oxygen to cells in the body, and it is involved in the functioning of the central nervous system. Without proper B12 intake, one can end up with anemia and weakness as well as numbing and tingling of the limbs. We need about 2.4mg of Vitamin B12/day. B12 is highest in mussels, crab, oysters, mackerel, prawns, salmon and kippers but cod, haddock and trout are also good sources of this nutrient.

Vitamin D is another nutrient that is often lacking in the North American diet, mostly due to the fact that our skin does not come into contact with the sun on a daily basis. Vitamin D is incredibly important in bone health and a deficiency is linked to osteoporosis. Vitamin D is also involved in the functioning of the immune system as well as disease and cancer prevention. Vitamin D is not found in all seafood, but great sources of Vitamin D include mackerel, trout, kippers and salmon. Tuna, sardines and haddock are also a source of Vitamin D.

Zinc is the final nutrient I chose to focus on. Zinc has a large role in the immune system as well as the nervous and reproductive system. Zinc’s role in the immune system has lead to the use of Zinc and Vitamin C supplements when fighting a cold. Zinc has many roles in the immune system, most notably that it is involved in the production and maturation of white blood cells, which kill viruses. We need about 11mg of zinc/day and we are not always meeting these needs. All seafood is a source of zinc with mussels, prawns, crab, kippers, oysters and sardines being excellent sources.

Other nutrients found in seafood include Vitamin A and Vitamin E, both which are powerful antioxidants, B vitamins (especially niacin and folate), calcium, potassium, phosphorus, magnesium, biotin, iodine and selenium.

It is recommended that we consume two servings of seafood/week. Switch up the sources of sustainable seafood in order to ensure a varied nutrient intake and choose seafood with omega 3’s often as well.

1. You have full control over the ingredients used. Frozen meals or pre-prepared/prepackaged meals are generally full of nutrients and ingredients that we don’t need or in which we get too much of in our diet. For example, processed foods are generally made with inexpensive oils such as corn oil, soybean oil, sunflower seed or safflower oil. These oils are high in omega 6 which causes an imbalance between omega 3 and omega 6. This imbalance is a risk factor for heart disease. Furthermore, store bought foods can be full of additives and preservatives including sugar and salt as well as dyes, chemicals, stabilizers and emulsifiers, etc.

Preparing meals allows you to control and choose each ingredient as well as portion size. You can decide on the levels and types of fats used, sugar content and sources and flavours used as well as the type and amount of vegetables used. You can choose local and/or organic ingredients (or not) and you can decide whether or not the animal products you use are grass fed or organically fed, lean or medium, etc.

2. Save money.Believe it or not, it is far less expensive to buy whole foods such as grains, fruits and vegetables and protein sources. When food costing for recipes, it is not uncommon for each serving of a recipe to cost as low as 30 cents- $2.00, depending on the recipe and ingredients. Not only can you prepare many servings of healthy recipes from one grocery order, but you will generally be left with extra food for snacks such as veggies and dip or extra grain to use in future recipes.

3. Cooking Can be Enjoyable and Relaxing. Although it is not uncommon to view cooking as a chore, meal prep is a great way to relax and wind down on a day off or after a long work/school day. While chopping vegetables for the recipe(s) chosen, you can listen to music or have a glass of wine or tea. Cooking with your friend, partner or children is a great way to communicate and spend time together as well. Children are far more likely to want to eat a meal that they helped prepare and teaching your children how to cook will set them on the right path for a healthy lifestyle.

The key to making food preparation enjoyable is to experiment and to allow for errors. Don’t worry if a recipe doesn’t turn out the way you thought it would as every cooking experience is a new adventure. Let your creative juices flow. Recipes are just a guide. Have fun in the kitchen!

4. Cooking allows for variety so you will never get bored of your diet.No two dishes need to taste the same. You can always prepare a recipe but switch out the flavours or vegetables used. You can also replace like for like in order to switch up the recipe a bit. For example, replace brown rice for brown rice noodles or chicken for lentils, etc.

5. You can create as many servings as you'd like for leftovers.Cooking your own food does not mean that you need to spend two hours in the kitchen everyday. You can double or triple a recipe based on the number of people eating and the amount of leftovers required for later in the week.

The best way to develop meal planning skills is to talk to a professional about your dietary needs and preferences so skill development is specific to your needs. If you have any questions, contact me at nicole.marchand@eatwellhalifax.ca.

As February is American Heart Health Month, I figured this would be the perfect opportunity to discuss how we can decrease our risk of heart disease through diet. Although genetics, age, environment and other non-diet related factors such as smoking and a sedentary lifestyle affect heart disease risk, I chose to focus on diet specifically for this article as up to 1/3 of mortality from cardiovascular disease is related to our dietary intake.

Below are 5 dietary lifestyle changes you can take to help promote a healthy heart throughout your lifetime. If you are interested in discussing an optimal diet for you in order to maintain a healthy heart, please contact me today at nicole.marchand@eatwellhalifax.ca or book online today at www.thefloatationcentre.ca.

1. Enjoy a well-balanced intake of protein, high fibre carbohydrates and fats.A well-balanced diet is the simplest way to reduce the risk of heart disease for several reasons. Eating healthy meals and snacks throughout the day helps decrease the risk for obesity, which is a risk factor for heart disease. If you are prone to weight gain around the waist, it is vital to stay at a healthy weight as central obesity increases the risk for heart disease. Obesity is related to low HDL cholesterol levels (the good cholesterol), raised triglycerides (fatty acids in the blood) and LDL cholesterol levels as well as high blood pressure and glucose intolerance, which are all related to heart disease.

A well balanced diet also promotes the intake of all vitamins and minerals, each having its own role in heart health. For example, potassium found in meat and dairy as well as grains, vegetables, nuts and seeds, protects against high blood pressure. Calcium, found in dairy, nuts, fish bones, green vegetables and legumes, also reduces blood pressure. Folic acid and other B vitamins protect against CVD as they lower homocysteine levels in the blood, an amino acid linked to heart disease.

2. Increase intake of fruits and vegetables.Fruits and vegetables are high in fibre, heart healthy vitamins and minerals and antioxidants as well as other disease fighting compounds such as polyphenols. Each colour of the rainbow found in fruits and vegetables represents various antioxidants associated with heart health. For example, Vitamin A, or beta carotene, found in orange and green vegetables is a potent antioxidant that reduces the oxidation of plaque on blood vessel walls.

3. Increase intake of dietary fibre and reduce intake of processed sugars.Fibre is found in fruits, vegetables and whole grains. Both types of fibre, soluble and insoluble, play a role in preventing heart disease. Insoluble fibre increases satiation, decreases blood sugar spikes and controls stool transit time. Soluble fibre helps decrease LDL cholesterol levels, a type of cholesterol related to heart disease.Although sugar is not directly linked to heart disease, refined sugar does increase triglyceride levels, (fatty acids in the blood). Furthermore, high sugar intake is linked to overweight and obesity which is also a risk factor for heart disease.

4. Reduce intake of sodium.As sodium promotes fluid retention, it influences blood pressure levels. High blood pressure, or hypertension, is a risk factor for heart disease. Although we can safely consume up to 2300mg/day, most North Americans consume double that amount. Up to 75% of our total sodium intake comes from packaged, processed and canned foods. Choose fresh grains, fruits and vegetables in order to decrease sodium levels and to keep your heart healthy.

5. Replace saturated and trans fats with unsaturated fats.Focus on increasing intake of unsaturated fats such as mono and polyunsaturated fats instead of focusing on decreasing overall fat intake (unless your intake is more than 35% of your total calorie intake). Our bodies rely on fat for cell membrane structure, fuel reserves, brain and heart health and absorption of fat-soluble vitamins, etc. Also, diets too low in fat reduce HDL, a protective form of cholesterol.

As saturated fat is converted to cholesterol in the body, it is important to take in saturated fats at no more than 10% total calorie intake. Although trans fats also increase LDL cholesterol levels, they also lower HDL levels and therefore, should be avoided as much as possible. Although a small amount is naturally found in meats and milk products, we can reduce our trans fat intake by avoiding partially hydrogenated oils and shortenings found in processed foods, commercial baked goods and deep-fried foods.

Unsaturated fats can help lower LDL cholesterol levels in the blood. Monounsaturated fat is found in nuts, seeds and vegetable oils. Polyunsaturated fats, such as the well-known Omega 3’s, are found in fatty fish, some nuts and seeds, and vegetable oils. Although it is recommended to include 2 servings of fatty fish in the diet/week, you can get omega 3’s from supplements as well, just make sure the brand is from a sustainable, pure source such as from sardines and anchovies which are low in contaminants and more sustainable than larger fish. Not only do Omega 3’s decrease LDL, they increase heart healthy HDL levels, they have anti-inflammatory and blood-thinning effects and they lower triglyceride levels, all which reduce the risk of heart disease.

It is challenging to write an article on the cost of eating locally when there are so many more costs to consider other than just what comes out of our wallets. However, I understand that the actual cost of food can create barriers to creating a healthy diet. Other barriers to eating healthy include a self perceived lack of ability to cook, time management, small kitchen space or storage space, etc.

Although dependent on the time of the year, method of production (organic or conventional), food preferences, food items and the store, with the right resources, seasonal foods can decrease your grocery bill. When it comes to fruits and vegetables, locally sourced produce is generally on par with or below imported prices. When local food is readily available such as apples, carrots, squash and potatoes in the fall, for example, they are generally less expensive when purchased locally than when imported. Even spinach, mixed greens and arugula can be less expensive than imported greens during peak season. Some exceptions may include imported berries, unless purchased at peak season or at U-Picks. Furthermore, it can sometimes prove difficult for local farmers to compete with imported goods, especially when larger scale grocery stores have sales and promotions.

As for protein sources, meat products from local suppliers who raise their animals more humanely than large scale farms are generally on par with or a bit more expensive than meat from animals raised on large scale, commercial farms. The biggest difference you’d see would be in poultry as there can be a big gap in the per pound price. I will note that “organic” eggs in the grocery store or “free run/range” eggs are comparable to the price at the farmer’s market or Local Source.

When comparing vegetarian protein sources, however, the prices are the same across the board, or similar enough. In saying that, a diet that includes local, seasonal foods could include vegetarian protein sources once in a while in order to decrease the total cost of protein. In fact, those on a seasonal diet can often rely heavily on legumes such as beans, lentils and dried peas, all of which are inexpensive. When it comes to using legumes, knowing how to use and cook them properly is necessary in order to be comfortable with replacing animal protein for vegetarian protein.

Finally, it may appear to be less expensive to buy ready-made pizzas, lasagnas, casseroles, etc., but I assure you in buying the ingredients to make all of these meals, not only will you save money per serving, you will have leftover groceries for preparing more meals. It is also far healthier to make a large dish of food for a couple of days than to buy a ready made dish which is often high in sodium and includes ingredients which do not provide our bodies with nourishment.​If you want to learn more about food preparation skills, time management skills, seasonal diets or are looking for cooking resources and recipes, contact me at nicole.marchand@eatwellhalifax.ca or book an appointment with me using the booking tab on my website.​Nicole Marchand, RD

​Cost of groceries from Local Source Market: $44.62This grocery order includes grains and starchy vegetables, various animal and vegetarian protein sources, dairy and seasonal vegetables. One can make 20+ servings of full meals with this grocery order.

​Cost of groceries from Local Source Market: $32.50This grocery order includes grains and starchy vegetables, vegan protein sources and seasonal vegetables. One can make about15 servings of full meals with this grocery order.

To be honest, there haven’t been many days in my adult years that did not include three squares of dark chocolate after dinner. I understand that some feel dark chocolate is too bitter, however, provided that the chocolate is at least 60% cocoa solids, there is a type or brand of dark chocolate available for most taste buds.

There are many health benefits related to dark chocolate intake and more research taking place that suggests cocoa can reduce the risk of cardiovascular disease and certain cancers. In fact, cocoa has been used historically as a medical remedy to prevent heart disease.

Cocoa solids are rich in powerful phytochemicals called flavanoids. These antioxidants protect the body’s cells from free radical damage and disease. There is also research suggesting that flavanoids inhibit the oxidation of LDL or “bad” cholesterol” which is associated with heart disease. This class of phytochemicals may also decrease blood pressure, another risk factor for heart disease.

Flavanoids have other properties as well that protect us from disease such as anti-inflammatory, anti-adhesive and anti-thombotic properties, all of which are associated with a decreased risk for heart disease.

Aside from antioxidants, cocoa butter has stearic acid, a long chained, saturated fat which may also have positive effects on cardiovascular disease risk factors.

Dark chocolate is incredibly satisfying and it can decrease after meal sugar cravings. If you are new to dark chocolate, try 2-3 squares of 60% dark chocolate to start. Bite each piece and chew slowly, letting the chocolate melt in your mouth before swallowing. Work your way up to higher cocoa percentages and try different styles of dark chocolate until you find the perfect one for you. A fantastic evening treat during the colder seasons is hot cocoa made from raw or unprocessed cocoa powder, milk and a bit of sugar.

As dark chocolate is high in calories, try to stick with just 2-3 squares in the afternoon, after a meal, or whenever you feel the need to have a small, sweet treat. Luckily, as dark chocolate is rich in flavour, that’s all you should need.

In a bowl mix lemon juice, curry and cumin, canola oil, salt and minced garlic. Coat chicken thighs with the marinade and set aside for a few minutes before placing in the oven for 30 minutes.

Once chicken is in the oven, prepare the sauce by combining all ingredients in a bowl (leave some fresh thyme for garnish) and refrigerate to combine flavours and to thicken.

After 30 minutes, remove thighs from the oven and serve the sauce on top or beside a chicken thigh with ½ cup cooked long grain, brown rice or ½ cup roasted potatoes, etc. and side vegetables of choice.

What to do with leftovers? For lunch, enjoy a chicken and yogurt sauce wrap with chopped tomatoes, mushrooms (optional) and kale or spinach inside a whole wheat pita.

Directions:1. Add a bit of oil to a large pot and bring to a medium heat. Add chopped onions for 5 minutes before adding potatoes, sweet potatoes, brussels sprouts (and other vegetables of choice) and the stock. Bring to a boil and then reduce heat, cover and simmer.2. Meanwhile, preheat a pan to medium heat with oil. Add chopped sausage and cooked until brown, about 10 minutes.3. Check the potatoes and once tender, add chicken sausage, Italian seasoning, salt and pepper and fresh thyme.4. Heat all ingredients together for a few minutes and season to taste.5. Serve with a slice of whole grain bread or high fibre crackers.

**Note: The stew will thicken over night for a heartier feel AND it makes fantastic leftovers to bring to work or school.

​I have been a consulting dietitian for over three years and regardless of the client’s dietary needs, wants and barriers, developing a positive relationship with food seems to be an obstacle for many people. Clients are often unsure of what to eat, how much to eat and what to avoid, etc. With all of the media and messages being sent our way, what does it mean to eat well? To eat a balanced diet? To eat normally? Does healthy eating mean to be on the paleo diet or to avoid gluten or to stop eating after 7pm?

Normal, or healthy, eating is to have a positive relationship with food. It is to have a healthy diet full of fibre, vegetables and fruits, proteins and fats and to eat an appropriate amount of energy based on your lifestyle (most of the time). Normal eating is sticking to a healthy diet with the ability to take a step outside of your regime in order to enjoy a treat without feeling guilt or shame and without giving up fully on a diet due to loss of motivation. For example, if you always have a healthy, mid-day snack at 3:30pm, it should be okay to switch up the healthy snack once in a while with a treat or to enjoy a few pieces of candy that your co-worker shared with you along with the healthy snack. Normal eating is being able to enjoy pizza and a glass of wine with your friends on a Thursday night only to go back to your healthy regime the next day.

So the question becomes, how do we allow ourselves to form a positive relationship with food? First of all, if you are unsure of how to follow a healthy diet based on your needs, your first step would be to set up a consultation with a professional dietitian such as myself so we can initiate a discussion on what it means to eat well for your specific situation. The second step would be to start incorporating a well-balanced diet into your regime and finally, to learn how to follow a healthy diet while treating yourself once in a while without feeling shamed or guilty.

It is SO easy sometimes for clients to try to follow a diet so strictly that ANY blunder could make them give up completely. Instead, allow yourself to have fun with your dietary intake and try new things, have treats and enjoy food. Don’t let one night out or even one week (or more) of an unhealthy diet set you back. We are all human and we all need to step outside of our regimes every now and then to feel our best.

Eating well is NOT about being on a strict diet, it is about taking care of yourself through your dietary intake while finding a balance to enjoy treats, evenings out and holidays, etc.

Note: The picture I chose for this post is perfect. Although I generally eat very well, a night of wine, bread and cheese with a friend or two has a special place in my diet and whatever you love to eat as a treat can have a special place in your healthy diet as well.

Caffeine is a mild stimulant that is found in coffee, tea, energy drinks, chocolate and even in some supplements and medications. According to Health Canada, caffeine intake for adults is safe up to 400mg/day. This amount equates to 3- 8oz cups of coffee/day. For women who are pregnant or breastfeeding, it is safe to have up to 300mg/day. If you are planning to become pregnant, it is best to follow the guidelines set for pregnant women.

Positive Effects of Caffeine/Coffee IntakeCaffeine intake can increase alertness and concentration in adults when taken in healthy amounts. As coffee is the main source of caffeine for adults in Canada, it is important to note that coffee itself contains antioxidants, which promote disease prevention, as as well potassium, magnesium, chromium, niacin (Vitamin B3) and manganese.

Although research is still being done, studies show that at safe amounts, caffeine does not contribute to heart disease, osteoporosis, cancer or infertility. Furthermore, scientific evidence does not support adversities such as miscarriages, low birth weights or congenital malformations when staying within safe levels.

Adverse Effects of Caffeine IntakeAdverse effects of caffeine intake (which take place generally when we go over the recommended amount) include sleep disturbance, headaches, irritability, GI disturbances and nervousness. More than 400mg/day can increase risk of cardiovascular disease as caffeine increases blood pressure and heart rate. Additionally, some people are naturally more sensitive to caffeine and can have adverse effects at lesser amounts.

Caffeine, Coffee and DiseaseIf living with low bone density, osteopenia, or osteoporosis, it is especially important to stay at or below 400mg/day. Too much caffeine can increase calcium excretion in urine and can decrease calcium absorption.

Although caffeine can cause the pancreas to work harder in order to clear sugar from the blood, coffee itself (even decaf) has actually been shown to protect against type 2 diabetes. Coffee is a source of an antioxidant (phytochemical) which improves insulin sensitivity and decreased glucose absorption.

In terms of Alzheimer’s disease, up to 3 coffees/day is associated with improved cognitive function and caffeine actually decreases amyloid plaque formation.

For those living with GERD, caffeine can decrease the pressure in the esophageal sphincter, causing symptoms. Therefore, if living with GERD you may have to decrease caffeine intake.

In conclusion, moderate caffeine intake for most adults is not related to side effects and can even be beneficial to health. However, if choosing to decrease caffeine intake, which is important especially if exceeding the safe limit, decrease intake gradually to avoid withdrawal symptoms.

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